Аннотация
Abstract Background: Previous studies from Western countries showed an association between maternal and infant mortality with sociomedical problems. The social environment influencing the health status of mothers and infants is thus seen to be a function of the economic resources and forms of production of different regions. This is the first study that includes the study of preventable mortality from Pregnancy, childbirth and perinatal period and Congenital malformations in Kazakhstan in the context of regions. For 2015-2019 maternal mortality decreased by 16.5% in the Republic of Kazakhstan. However, since the start of the pandemic in 2020, the maternal mortality ratio has increased by 2.7 times. This study aimed to provide the latest policy in maternal and infant mortality, and analyze their mortality ratios. Methods: An appraisal was conducted of regulatory documents related to the maternal and child health last ten years in the Kazakhstan health system. To identify changes in avoidable mortality ratio trends for the period 2011-2021, join point regression was used to calculate the average annual percentage change for every age group by using the Join Point Regression Program, Version 4.9.1.0. Results: Crude mortality associated with pregnancy and childbirth and the postpartum period were high in the 30-34 age group from 2015 to 2018. From 2019 to 2021, there has been an increase in mortality in the 35-39 age group from 0.48 (95% CI: - 0.06; 1.03) to 4.37 (95% CI: 2.83; 5.91) per 100,000 women. In general, in all age groups, there is a twofold increase in mortality in the period from 2018-2021. Treatable mortality from pregnancy, childbirth and the puerperium fluctuated from 2015-2019 between 0.34 to 0.37 after which rose till 1.07 in 2021 per 100.000 population. The highest increase can be seen in Atyrau, South and East Kazakhstan, Karagandy and Almaty regions. The treatable mortality decreased in Kyzylorda, Akmola regions in the 2015-2021 period. Conclusion: Several regions need to step up efforts to reduce maternal mortality, which remains high nationally compared to OECD countries. This is the first study to examine the prevention of deaths from pregnancy, childbirth, and the perinatal period, as well as the development of birth defects in Kazakhstan by region, which helps physician decision-makers reconsider possible approaches to providing care at the primary health care level.